Sharing & Wearing Flowers for Women's Pelvic Health

September 26, 2013April 28, 2015

Cross Fit: Fit for Pregnant Women?

Hey-oohhhh, Share MayFlowers crew….it has been a while.

Mounds going on, lots to share, and we’ll start with the following posts. First, a post from Emily Oster’s Facebook page (author of the recently-released pregnancy book, Expecting Better) regarding debate over a woman posting CrossFit pics of herself in her 3rd trimester. Second, my “comment” to her post…which I admit was way too long for Facebook etiquette. My bad.

After approximately a million people shared this with me I have felt compelled to comment on the pregnant weight lifter (link is below in very unlikely event you have not seen). I should open by saying the first thing I thought when I saw the photo was that those are awesome socks. A lot of the discussion has revolved around the general topic of “exercise in pregnancy”. I think it’s first worth noting that we should separate the aerobic exercise issue from the lifting-heavy-things issue. I spent some time in my Slate blog (the post is here) on aerobic exercise. There, the concern is getting your blood pressure up too high. Perhaps the woman in the photo is also doing a lot of aerobic exercise, but weight lifting alone like this seems very unlikely to raise her heart rate to 90 percent of maximum, which is where it looks like blood flow to the baby might be compromised. This is actually separate, however, from the question of whether lifting heavy weights during pregnancy puts women at risk. Studies of this have mainly focused on women who do lifting for a job — which does introduce problems like that kind of women who have jobs involving heavy lifting tend to be different in other ways from women who do not — and they do seem to find some small negative impacts. A 2013 review (you can see the abstract here suggests that there may be some downsides, but they are small. And, of course, there are upsides to being in good shape for labor, recovery, etc. http://well.blogs.nytimes.com/2013/09/24/pregnant-weight-lifter-stirs-debate/?_r=0

My Response to her Post:

Hi Emily- I have to admit my first thought was, “Her right lower extremity is externally rotated more than the left,” followed by “Wow, my cleavage never looked that good, “ followed by, “Man, she is strong!” However, my first thought when looking at the thoughts of other’s on Ms. Ellison’s CrossFitting decisions was, “Why is there no concern for mama’s body in this debate?” The concerns cited by others appear predominantly focused on the fetus, with the studies cited similarly focused (pre-term delivery, low birth weight), save for the additional factoring-in of preeclampsia. I see a situation like this, count on evolutionary biology to protect the fetus through all manner of otherwise unfavorable circumstances, but count on only the mother’s coordination of her deep stability system – the deep abdominals, pelvic floor muscles, and respiratory diaphragm – to keep her uterus inside her body for the long run. And lots of things – related to life in general, exercise, and pregnancy and childbirth – have the potential to muck that up. A just-published review of the literature reports “some evidence linking strenuous physical activity with pelvic organ prolapse but this is neither consistent nor adequately powered to reach any firm conclusions,” but goes on to state that there is “a marked paucity of literature relevant to the research question (that) makes it difficult to draw firm conclusions.” A previously published report in 2009, discusses the role of obstetric and non-obstetric factors in development of pelvic organ prolapse. It suggests that heavy lifting is a factor and says conclusively that parity is a factor (leaving me to wonder what does risk look like when both are combined…?). Beyond all this, CrossFit has recently come under scrutiny for accepting “exercise-induced urine leakage”, aka “stress urinary incontinence”, as proof-positive of the workhorse ethic espoused by many (after the release of this CrossFit video), but colleagues of mine have reason to believe that many CrossFitters actually want information on how to integrate pelvic floor training into global strength and conditioning. Great news, since both stress urinary incontinence and pelvic organ prolapse share risk factors. So time will tell (because it hopefully will lead to more research) the degree to which exercise involving impact and/or heavy lifting in life and during pregnancy brings risk to the mother in the short and long term, and how much any risk might be mitigated with good technique and integrative pelvic floor training. For now, I am quite impressed with Ms. Ellison’s obvious capabilities, think her baby will be just fine, and hope she is exhaling and engaging her deep stability system with every heavy rep.